ObjectiveTo explore the continuous care demands in liver transplant recipients and the influencing factors. MethodFrom October to December 2013, 235 liver transplant recipients were investigated with self-designed questionnaire to learn their continuous care demands. Factors affecting demands for continuous care were analyzed with single factor Chi square analysis and binary logistic regression analysis. ResultsA total of 130 recipients (55.3%) needed continuous care. Single factor chi-square analysis showed that three factors including complications, re-hospitalization and time to get to the nearest medical organization were significant for continuous care demands (P<0.05). Binary logistic regression analysis showed that the longer the time spent by liver transplant recipients to reach the nearest medical organization was, the more they hoped for continuous care[OR=3.040, 95%CI (1.585, 5.829), P=0.001]; the patients with readmisson within one year after surgery hoped less continuous care[OR=0.515, 95%CI (0.292, 0.907), P=0.022]. ConclusionsAt present, acceptance degree for continuous care in the liver transplant recipients is quite high. In the continuous care research and practice, we should develop new models and tools to shorten the time and distance between nurses and patients so as to meet the individualized care demands of the patients and improve their quality of life.
Objective To explore the application of fast track surgery (FTS) mode through multidisciplinary cooperation for the perioperative period of liver cancer. Methods A total of 188 patients with liver cancer treated between April and December 2014 were randomly divided into two groups: FTS group (n=94) and control group (n=94). The FTS group was treated with multidisciplinary cooperative FTS mode, while the control group was treated with traditional perioperative treatment. The self-care ability of daily life, pain, ambulation time and frequency, anal exhaust time, defecation time, hospital stay, hospitalization expenses and readmission rate were compared between the two groups. Results Compared with the control group, patients in the FTS group had a better ability of self-care one to three days after surgery, more reduced pain 8, 24 and 48 hours after surgery, more frequent ambulation and longer ambulation time three days after surgery, shorter time of defecation and exhaust, shorter hospital stay and lower hospitalization expenses. All the above differences were statistically significant (P<0.05). The readmission rate, self-care ability four to seven days after surgery, pain scores 72 and 96 hours after surgery were not significantly different (P>0.05). Conclusion Multidisciplinary cooperative FTS mode for liver cancer perioperative rehabilitation can improve patients’ self-care ability, promote a speedy recovery, reduce hospitalization costs, save medical resources and improve disciplinary teamwork ability.
ObjectiveTo investigate status of readiness for hospital discharge of patients with liver cancer after radical surgery and to explore its influencing factors.MethodsA cross-sectional survey was conducted, a total of 200 patients with liver cancer after the radical resection who were planned to discharge within 1 to 2 days in this hospital from January to April 2019 were selected as the study subjects. The general informations and informations relevant readiness for hospital discharge of patients were investigated and analyzed by the questionnaire.ResultsIn this study, 200 questionnaires were distributed, of which 195 were recovered, and 184 were valid, the final effective recovery rate was 92% (184/200). The scores of 4 dimensions of readiness for hospital discharge in 184 patients: The own status was 42.55±12.36, disease knowledge was 51.68±17.58, and response ability was 21.05±6.86, social support available was 31.85±7.56, and the total score of readiness for hospital discharge was 147.07±36.25. One hundred and eighty-four (80.4%) of 184 patients were prepared to discharge. The univariate analysis results showed that the readiness for hospital discharge score was related to the gender, monthly income per household, preoperative comorbidities, and time with tube after the operation (P<0.05); Further the multiple regression analysis showed that the monthly income per household and preoperative comorbidities were the important influencing factors for it (P<0.05).ConclusionsAccording to results of this study on readiness for hospital discharge of patients with liver cancer after operation in this hospital, readiness for hospital discharge is better, and gender, monthly income per household, preoperative comorbidities, and time with tube after operation are influence factors for it, of which monthly income per household and preoperative comorbidities are important influencing factors.
Objective To explore how to integrate the various sources of information in designing an evidence-based nursing care plan for preventing gastrointestinal hemorrhage (GIH) after pancreaticoduodenectomy (PD). Method Papers and references about prevention of GIH after PD were searched between September and October 2015, and an evidence-based nursing care plan was drawn up and implemented from November 2015 to January 2016. Results A total of 79 papers were found and of which 17 were aviliable. Thirty-nine patients were cared on the basis of the effective project, of whom one was dignosed with GIH on the 3rd postoperative day and the rate of post-PD hemorrhage was 2.6%. All patients were diacharged on the 6th or 7th postoperative day. Conclusion Exploring evidences under the guidance of scientific method and applying them to clinical nursing can prevent post-PD hemorrhage and improve life quality of patients.
Objective To analyze the risk factors associated with fungal infections in adult recipients after living donor liver transplantation (LDLT). Methods Data of 189 recipients from January 2006 to December 2012 who received LDLT at our center were retrospectively analyzed. Cox regression analysis was used to analyze the risk factors for postoperative fungal infections. Results Postoperative fungal infection was found in 12 recipients. The most common infectious site was lung, whereas the most common fungal pathogen was Candida albicans. Multivariate analysis suggested preoperative low albumin level [HR=0.792, 95%CI (0.694, 0.903), P=0.001], massive intraoperative red blood cell transfusion [HR=4.322, 95%CI (1.308, 14.277), P=0.016] and longer postoperative intensive care unit (ICU) stay [HR=3.399, 95%CI (1.004, 11.506), P=0.049] were the independent risk factors for postoperative fungal infections. Conclusions Lung is the most common fungal infection site after LDLT. Preoperative low albumin level, massive intraoperative red blood cell transfusion and longer postoperative ICU contribute to fungal infections after LDLT.
ObjectiveTo explore the application effect of itinerant strengthening post in ophthalmic day operating room.MethodsIn June 2019 (before the establishment of the itinerant strengthening post) and January 2020 (after the establishment of the itinerant strengthening post), satisfaction of 21 ophthalmic surgeons in the ophthalmic day operation room of the West China Hospital of Sichuan University on intraoperative nursing cooperation, and coping ability scores of operation in key links, satisfaction with scheduling and workload, as well as complaints and accusations received by surgeons of 15 ophthalmological nurses in the ophthalmic day operation room of the West China Hospital of Sichuan University were collected. The total volume of eye day surgeries and the length of the day operating room open in the second half of 2018 and 2019 were retrospectively collected.ResultsAfter the establishment of the itinerant strengthening post, the coping ability score of operation in key links of ophthalmological nurses was improved [(3.28±0.72) vs. (4.67±0.72), P<0.01]. In terms of surgeons’ satisfaction with intraoperative nursing cooperation, with the exception of aseptic operation, the other items were improved (P<0.05). The surgical nurses’ satisfaction with scheduling and workload [(3.30±0.77) vs. (4.47±0.67), P<0.01]; nurses’ complaints and accusations received by surgeons [(3.60±1.18) vs. (2.33±0.82), P<0.01] were improved. The volume of eye day surgery from July to December 2019 increased by 6.58% over the same period in 2018, and the average open time of the operating room increased by 1.88%.ConclusionThe setting up of itinerant strengthening posts in the ophthalmology day operation room is conducive to strengthening the strength and business guidance of the nurses’ key links in the operation room in a timely and effective manner. It can optimize the allocation of human resources in the operating room as much as possible when the existing nursing staff is in short supply, and improve the quality and efficiency of ophthalmic surgery nursing, which is worthy of promotion and application.
Objective To investigate the risk factors and prevention methods of the venous thromboembolism (VTE) after hepatectomy. Methods The literatures about VTE after hepatectomy in recent years at home and abroad were reviewed and summarized. Results The risk factors for postoperative VTE include tumor, male, old age, massive hepatectomy, hypercoagulability, etc. The incidence of VTE in patients with massive hepatectomy is significantly higher, which is closely related to the hypercoagulability caused by postoperative liver dysfunction. Effective prophylaxis include mechanical methods and anticoagulant drugs, the latter of which can markedly reduce the incidence of VTE. For patients who develop postoperative liver insufficiency, including those with cirrhosis and high risk of bleeding, anticoagulant VTE prophylaxis dosing decisions should be made with caution. In addition, it is rationale for extended thromboprophylaxis in high risk patients. Conclusions VTE is a common complication after hepatectomy, resulting in prolonged postoperative hospital stay and increased postoperative mortality. Therefore, it is important to determine the risk of VTE after surgery to improve the prognosis of patients after hepatectomy.